单克隆抗体OC_(859)治疗对卵巢癌患者生存率及免疫系统的影响

Effect of immunotherapy with the monoclonal antibody OC_(859) on survival rate and immunoreaction of patients with ovarian cancer

目的探讨单克隆抗体(单抗)OC859治疗对卵巢癌患者生存率及免疫系统的影响。方法对用单抗OC859治疗105例(单抗组)及未用单抗的126例(对照组)卵巢癌患者进行回顾性分析,比较两组患者的生存率。并测定单抗组部分患者血清人抗鼠抗体(HAMA)(25例)和T细胞亚群(15例)的改变。结果两组年龄、满意的肿瘤细胞减灭术比例、病理类型、分期、分化均无显著性差异。单抗组平均化疗10.9疗程,对照组平均化疗8.2疗程,两组有显著性差异(P<0.01)。单抗组平均生存时间、3及5年生存率分别为(91±6)个月、65.7%和62.2%,而对照组分别为(62±7)个月、41.1%和36.2%,均有极显著性差异(P均<0.001)。单抗组治疗后HAMA滴度明显升高。在单抗治疗前患者外周血CD4/CD8比值低于正常水平,单抗治疗一次后CD4/CD8比值大部分达正常水平,治疗两次后全部达正常水平。结论单抗OC859治疗使卵巢癌患者的3及5年生存率均明显提高,患者的免疫系统均有明显改变。在手术和化疗的基础上单抗OC859有助于卵巢癌的治疗。

Objective: To evaluate the effect of the monoclonal antibody(MAb) OC_ 859 on the survival and immunoreaction of patients with ovarian cancer.Methods: 105 cases with MAbOC_ 859 therapy (MAb group) and 125 cases without MAbOC_ 859 therapy (control group) of ovarian cancer were studied retrospectively. Human anti-mouse antibody (HAMA) in 25 patients and the T cell subsets in 15 patients were also examined.Results: No significant differences were found in age, first cytoreductive surgery, FIGO staging, histological type and pathological grade between the MAb group and control group, but the mean number of chemotherapy courses in the MAb group was longer than that in the control group (10.9 vs 8.2 respectively, P<0.01). The mean survival time in the MAb group and control group was (91±6) months and (62±7) months respectively; the 3-year survival rate, 65.7% and 41.1% respectively; the 5-year survival rate, 62.2% and 36.2% respectively (P<0.001). HAMA titers were significantly elevated after MAbOC_ 859 treatment. The results showed that the ratio of CD_4/CD_8 in patients with ovarian cancer was much lower than that in women without the disease. It came to normal after one course of the MAbOC_ 859 therapy in majority of the patients and after two courses it became normal in all of the patients. Conclusion: The MAbOC_ 859 therapy significantly improved the survival and immunological responses of patients with ovarian cancer. These data suggest that the application of the MAbOC_ 859 has some therapeutic beneficial effects on patients with ovarian cancer.